Klinik Uygulama Rehberleri

Yıl 2015, Cilt: 23 Sayı: 1, 76 - 82, 22.05.2015

Aslı Kurtcu Nezihe Kızılkaya Beji

Öz

Klinik Uygulama Rehberleri (KUR), son yıllarda profesyonel karar vermeyi destekleyen köşe taşları olmuş ve rutin klinik uygulamalarda kilit bir rol üstlenmiştir. KUR “mevcut en iyi kanıtı” sentezlemek ve yayınlamak amacıyla kanıta dayalı tıp hareketinden ortaya çıkmıştır. Bu makalede, klinik uygulama rehberlerinin tanımı, klinik uygulama rehberlerinin yararları ve klinik uygulama rehberlerinin oluşturulması açıklanmıştır. Konuyla ilgili yayınlar geriye dönük olarak taranmıştır. Bu amaçla İstanbul Üniversitesi internet erişim ağı üzerinden klinik uygulama rehberleri (clinical practice guidelines), kanıta dayalı tıp (evidence-based medicine) ve hemşirelik (nursing) gibi anahtar kelimelerle çeşitli kombinasyonlar yapılarak Pub Med, Science Direct, CINAHL ve Medline veri tabanlarından tarama yapılmıştır. 2000-2014 tarihleri arasında yayınlanan ulusal ve uluslararası yayınlar gözden geçirilmiştir. KUR özel klinik durumlarda, sağlık çalışanları ve hastaların, bakıma yönelik uygun kararları vermelerine yardımcı olmak amacıyla tasarlanmış sistematik açıklamalardır. Kanıta dayalı klinik rehberler, hemşirelik kuramlarının uygulamaya dönüştürülmesi için bir yöntem sunar ve klinikteki yetersiz uygulamaların ortadan kaldırılmasını sağlar.

Anahtar Kelimeler: Klinik rehberler, kanıta dayalı uygulama, hemşirelik.

Anahtar Kelimeler

Klinik rehberler, kanıta dayalı uygulama, hemşirelik

Clinical Practice Guidelines

Öz

Clinical Practice Guidelines (CPGs), have been a cornerstone of professional decision support in recent years and have come to play a pivotal role in routine clinical practice. CPGs arise from the evidence-based medicine movement, aiming at synthesizing and disseminating “the best available evidence”. In this article, defi nition of clinical practice guidelines, advantages of clinical practice guidelines and development of clinical practice guidelines are explained. Relevant publication were screened retrospectively. This purpose, search was conducted from İstanbul University internet access across the network, database were used such as Pub Med, Science Direct, CINAHL and Medline various combination were made keywords such as clinical practice guidelines, evidence-based medicine and nursing. Published between the years 2000-2014, the national and international articles were reviewed. CPGs are systematically developed statements to assist practioners and patient desicions about appropriate health care for specifi c clinical circumstances. Evidence-based clinical guidelines provide a method of turning nursing theory into practice and ensuring that the profession rejects ineffective practices.

Key Words: Clinical guidelines, evidence based practice, nursing.

Anahtar Kelimeler

Clinical guidelines, evidence based practice, nursing

Kaynakça

• Ahmed, A. İ., Soliman, S. M., Awad, L. A. (2012). Validation of evidence-based clinical practice guideline: Nursing intervention for newly diagnosed pulmonary tuberculosis patients at commu- nity setting. Alexandria Journal of Medicine, 48(2): 155-165.
• Alanen, S. ve ark. (2009). Nurses’ experiences of guideline imp- lementation: A focus group study. Journal of Clinical Nursing, 18(18): 2613-2621.
• Andrews, M., Roberts, D. (2003). Supporting student nurses lear- ning in and through clinical practice: The role of the clinical guide- line. Nurse Education Today, 23(7): 474-481.
• Attia, A. (2013). Adaptation of international evidence based clini- cal practice guidelines: The ADAPTE process. Middle East Ferti- lity Society Journal, 18(2): 123-126.
• Bahtsevani, C., Willman, A., Stoltz, P., Ostman, M. (2010). Expe- riences of implementation of clinical guidelines – interviews with nurse managers and nurse in hospital care. Scandinavian Journal of
• Empirical Studies, 24(3): 514-522. Çavdar, İ. (2007). Klinik rehberlerin kullanımı. Türk Cerrahi ve Ameliyathane Hemşireliği Kongresi (Uluslararası katkılı) Kitabı,
• Ege Üniversitesi Basımevi, Bornova, İzmir, 65-66. Dans, A. M., Dans L., Oxman, A. D., Robinson, V., Acuin, J. (2007). Assessing equity in clinical practice guidelines. Journal of
• Clinical Epidemiology, 60(6): 540-546. Darling, G. (2002). The impact of clinical practice guidelines and cli- nical trials on treatment decisions. Surgical Oncology, 11(4): 255-262.
• Deurenberg, R. ve ark. (2007). Standartization of search methods for guideline development: An international survey of evidence- based guideline development groups. Health Information and Lib- raries Journal, 25(1): 23-30.
• Fervers, B., Carretier, J., Batailard, A. (2010). Clinical practice gu- idelines. Journal of Visceral Surgery, 147: 341-349.
• Goud, R., Hasman, A., Strijbis, A. M., Peek, N. (2009). A parallel guideline development and formalization strategy to improve the quality of clinical practice guidelines. International Journal of Me- dical Informatics, 78(8): 513-520.
• Graham, R. P., James, P. A, Cowan, T. M. (2000). Are clinical prac- tice guidelines valid for primary care? Journal of Clinical Epide- miology, 53(9): 949-954.
• Hollon, S. D., Arean, P. A., Craske, M. G., Crawford, K. A., Kiv- lahan, D. R. (2014). Development of clinical practice guidelines.
• Annu. Rev. Clin. Psycol, 10: 213-241. Kanan, N. (2007). Klinik rehberlerin kullanımı. Türk Cerrahi ve Ameliyathane Hemşireliği Kongresi (Uluslararası katkılı) Kitabı,
• Ege Üniversitesi Basımevi, Bornova, İzmir, 63-64. Koh, S. S. L., Manias, E., Hutchinson, A. M., Donath, S., Johnston, L. (2008). Nurses’ perceived barriers to the implementation of a
• Fall Prevention Clinical Practice Guideline in Singapore hospitals. BMC Health Service Research, 8: 105. May, C., Sibley, A., Hunt, K. (2014). The nursing work of hospital- based clinical practice guideline implemention: An explanatory systematic review using Normalisation Process Theory. Internatio- nal Journal of Nursing Studies, 51(2): 289-299.
• Miller, M., Kearney, N. (2004). Guidelines for clinical practice:
• Development, dissemination and implementation. International Journal of Nursing Students, 41(7): 813-821. Moriera, T., May, C., Mason, J., Eccles, M. (2006). A new met- hod of analysis enabled a better understanding of clinical practice guideline development process. Journal of Clinical Epidemiology, 59(11): 1199-1206.
• Penney, G., Foy, R. (2007). Do clinical guidelines enhance safe practice in obstetrics and gynaecology. Best Practice & Research
• Clinical Obstetrics and Gynaecology, 21(4): 657-673. Pilling, S. (2008). History, context, process, and rationale for the development of clinical guidelines. Psychology and Psychotherapy:
• Theory, Research and Practice, 81(Pt 4): 331-350. Roberts, W. D., Patel, V. L., Stone, P. W., Bakken, S. (2006). Know- ledge content of advanced practice nurse and physician experts:
• A cognitive evaluation of clinical practice guideline comprehen- sion. Park, H., Murray, P., Delaney, C. (Ed.). Consumer-Centred Computer-Supported Care for Healty People. IOS Press Ebooks, 476-4
• Rosenfeld, R. M., Shifman, R. N. (2009). Clinical practice guide- line development manual: A quality-driven approach for transla- ting evidence into action. Otolarngology-Head and Neck Surgery, 140(6): 1-43.
• Scott, I. A., Denaro, C. P., Bennett, C. J., Mudge, A. M. (2004). To- wards more effective use of desicion support in clinical practice:
• What the guidelines for guidelines don’t tell you. Internal Medici- ne Journal, 34(8): 492-500. Shackelton, R. J., Marceau, L. D, Link, C. L., McKinlay J. B. (2009).
• The intended and unintended consequences of clinical guidelines. Journal of Evaulation in Clinical Practice, 15(6): 1035-1042.
• Twaddle, S. (2005). Clinical practice guidelines. Evidence-Based
• Medicine and Healhcare, 46(12): 681-687. Van der Wees, P. J. ve ark. (2011). Development of clinical guideli- nes in physical therapy: Perspective for international collaboration.
• Profession Watch, 91(10): 1551-1563.
• Viktrup, L., Summers, K. H., Dennett, S. L. (2004). Clinical prac- tice guidelines on the initial assesment and treatment of urinary in- continence in women: A US focused review. International Journal of Gynecology and Obstetrics, 86(1): 25-37.
• Vogel, L. (2011). The practicality of practice guideline. Canadian
• Medical Assocation Journal, 183(18): E1295-E1296.
• Yakışan, R. Ş., Set, T. (2013). Klinik uygulama rehberleri. Turkish Jo- urnal of Family Medicine and Primary Care (TJFMPC), 7(2): 26-28.
• Yang, W., Chiang, I. (2006). EBCPG: A visualized evidence-based clinical practice guideline system. Park, H., Murray, P., Delaney,
• C. (Ed.). Consumer-Centred Computer- Supported Care for Healty People. IOS Press Ebooks, 465-470. Weijden, T., Boivin, A., Burgers, J., Schünemann H. J., Elwyn, G. (2012). Clinical practice guidelines and patient aids. An inevitab- le relationship. Journal of Clinical Epidemiology, 65(6): 584-589.